Session Descriptions Audiology 2015: Quality Outcomes for Cochlear Implants

These pre-recorded lectures are on-demand and last only an hour, so you can listen to them whenever time permits!

Measuring Outcomes in Cochlear Implants
Holly F. Teagle, AuD, CCC-A, Jeffrey L. Simmons, MA, CCC-A, and René H. Gifford, PhD, CCC-A

This session will review current information on best practices assessment of cochlear implant outcomes for adults and children as well as descriptions of current implant candidacy and the longitudinal assessment of performance for implant recipients with various communication modalities, including single implant, bimodal hearing, bilateral implantation, and hearing preservation.

After completing this session, you will be able to:

  • Identify current cochlear implant and auditory brainstem indications for adults and children
  • Describe recommended assessment tools and techniques for use with adults and children
  • State expected outcomes for adults and children with various hearing modalities

Cochlear Implants: Candidacy, Outcome, and Predictors of Success
René H. Gifford, PhD, CCC-A

Though cochlear implantation is recognized by government and private insurers as well as national organizations for audiologists and otologists as a standard of care and covered intervention, adults and children with severe to profound sensory-based hearing loss who meet labeled indications still have relatively low rates of access to this technology. This session will review a brief history of implant candidacy and outcomes and will discuss the evolving state of labeled indications, technological advances, and expected outcomes for modern-day recipients. In addition, the session will provide an overview of preoperative predictors of postoperative success, describing the outcomes of a prospective, longitudinal study of acoustic and electric spectral resolution and speech recognition performance in adult cochlear implant recipients at three clinically diverse cochlear implant centers.

After completing this session, you will be able to:

  • State the current labeled indications for adult and pediatric cochlear implantation
  • Identify the range of expected outcomes for adults and children receiving cochlear implants
  • List the current predictors of success as compared to historical data in the literature, including measures of spectral resolution obtained preoperatively and immediately following device activation

Telepractice for Cochlear Implants
Michelle L. Hughes, PhD, CCC-A

There are a few studies that have empirically evaluated the feasibility of mapping adult cochlear implant recipients using distance or remote technology, commonly known as telepractice. However, in order for telepractice to be successful for cochlear implant service delivery, all aspects of a typical clinical visit need to be validated for patients of all ages. This session will review the pertinent literature regarding telepractice with cochlear implants, identify gaps in the research, and discuss recent research findings from a current NIH-funded project aimed at improving service delivery via telepractice for cochlear implant recipients.

After completing this session, you will be able to:

  • Identify which clinical cochlear implant procedures have been empirically evaluated for telepractice
  • Describe the outcomes of these previously published studies
  • Describe recent research outcomes aimed at overcoming current barriers to remote delivery of cochlear implant services

Third-Party Reimbursement for Cochlear Implant Services
Lisa M. Satterfield, MS, CCC-A

Medicare, Medicaid, and private insurance often include cochlear implants as covered items, but frequently providers don't receive payment because of incorrect coding or documentation, or as a result of unfamiliarity with payment rules. This session will outline the billing codes for cochlear implants, the Medicare benefit, Medicaid trends, and how to obtain information from private insurance companies.

After completing this session, you will be able to:

  • Create a charge sheet for cochlear implant services using the appropriate CPT codes
  • differentiate a gene from a sequence of DNA;
  • Receive reimbursement for services provided to Medicare beneficiaries
  • Explain the Medicaid and private payer benefit information to patients

Cochlear Implants: New Indications
Camille Dunn, PhD, CCC-A

With the recent FDA approval of the hybrid cochlear implant, it is important for audiologists to know what makes a patient a candidate for this new type of intervention technology. This session will explore hearing preservation cochlear implants and what makes someone a good candidate. Additionally, we will discuss potential outcomes and the importance of counseling on rehabilitation options.

After completing this session, you will be able to:

  • Assess audiograms to determine benefit from hybrid cochlear implant technology
  • Describe the outcomes associated with cochlear implantation in different populations of listeners with hearing loss
  • Determine appropriate points of emphasis when counseling patients on cochlear implant benefits

Phonological Awareness in Students with Hearing Loss
Linda J. Spencer, PhD, CCC-SLP

For children with hearing loss, learning to read may be more challenging than for their peers because the ability to read relies on understanding how sounds combine to make words in addition to language ability, knowing how context influences meaning, and word–world knowledge. When working with students who are deaf or hard of hearing, practitioners may not always know how to incorporate all these elements into lesson plans. This session will provide background on specific issues related to hearing loss and acquisition of reading skills, and it will also provide ideas for evaluation and treatment of deficit areas.

After completing this session, you will be able to:

  • Describe the difference between sound production, phonological awareness, and phonological processing
  • Explain the rationale for targeting phonological awareness and phonological processing exercises with children who have hearing loss
  • Create three to five activities related to various levels of phonological awareness and phonological processing

Effects of Early Auditory Experience on Word Learning
Derek M. Houston, PhD

This session will examine evidence that early auditory deprivation can lead to an impaired ability for children with hearing loss to associate what they hear with what they experience visually. Participants will learn to think outside the ear when assessing and treating children with hearing loss.

After completing this session, you will be able to:

  • Describe how to assess novel word learning
  • Explain how auditory deprivation can affect the ability to associate spoken words and visual objects
  • Identify the effects of hearing loss beyond hearing

Auditory Brainstem Implants in Children
Holly F. Teagle, AuD, CCC-A, and Craig Buchman, MD, FACS

The use of auditory brainstem implants in children has received considerable attention in recent years. This session will share early findings from a University of North Carolina feasibility study designed to demonstrate the safety and efficacy of the Nucleus 24 Multichannel Auditory Brainstem Implant in children who do not have the diagnosis of neurofibromatosis type II and who have either experienced failed cochlear implantation or have been unable to receive a cochlear implant secondary to cochlear or cochlear nerve disorders. We will discuss aspects of patient care including candidacy criteria, medical/surgical considerations, audiological follow-up, and habilitation.

After completing this session, you will be able to:

  • Identify potential candidates for auditory brainstem implant
  • Explain differences in auditory brainstem implant surgery and follow-up care relative to what is known with cochlear implant recipients
  • Describe the impact of individual differences in clinical outcomes

Speech Development in Bilingual Children With Hearing Loss Who Use Cochlear Implants
Ferenc Bunta, PhD and Michael W. Douglas, MA, CCC-SLP

Bilingual children living in the U.S. are often at risk for not receiving appropriate speech and language services, and this is even more likely among bilingual children with hearing loss who use cochlear implants. This session will examine empirical data on speech acquisition to help audiologists and speech-language pathologists make more informed decisions regarding the assessment and treatment of the speech and language of bilingual children with cochlear implants.

After completing this session, you will be able to:

  • Identify phonological characteristics of the speech of bilingual children with hearing loss who use cochlear implants
  • Describe best practices for supporting the speech and language of bilingual children with hearing loss who use cochlear implants

Music in Auditory Intervention for Cochlear Implant Users
Kate E. Gfeller, PhD, and Virginia Driscoll, MA

Conventional cochlear implants are not particularly effective at transmitting spectrally complex information, which has a negative impact on perception of speech in background noise, speech prosody, talker identification, and perceptual accuracy and enjoyment of music. This session will describe extant findings on music training, including the growing body of research and clinical literature on generalization of music training to some spectrally complex aspects of speech perception, with empirical evidence as well as clinically suitable methods and applications. We will discuss several training approaches intended to enhance bottom-up as well as top-down aspects of listening in relation to the hearing history (pre-lingual, post-lingual) and developmental characteristics of the cochlear implant patient seeking aural rehabilitation.

After completing this session, you will be able to:

  • Describe the similarities and differences between the structural components of music and speech in relation to cochlear implant design and perceptual accuracy
  • Outline current research evidence regarding music training for cochlear implant patients
  • Describe different approaches to music-based training and the applications of each in relation to patient needs and characteristics

Auditory Development in Complex Cases
Catherine C. Carotta, EdD, CCC-SLP, and Katie R. Brennan, MD, CCC-SLP

This session will take a holistic approach to auditory development, exploring other aspects of development that may impact progress with amplification. Participants will have opportunities to observe a variety of children, with a focus on complex cases. We will present a variety of tools and procedures to assess a student's functional listening skills in addition to a hierarchy of more traditional speech perception measures. The session will use communication continuums to describe a child's preferred receptive and expressive communication methods, and we will also discuss family goals.

After completing this session, you will be able to:

  • Describe a child's placement on the auditory-to-visual communication continuum
  • Identify factors that may affect a child's auditory development
  • Identify appropriate times to refer to other specialists

Infusing Audition in the Home and Classroom
Catherine C. Carotta, EdD, CCC-SLP, and Katie R. Brennan, MD, CCC-SLP

Developing auditory skills in the therapy room does not ensure auditory development will occur in the home, daycare, or classroom environment. This session will provide the theoretical background and rationale for implementing routine- and activity-based instruction to assist with auditory development across settings. We will introduce a variety of routine-based inventory tools, planning frameworks, and monitoring mechanisms for infusing auditory development in home and classroom settings.

After completing this session, you will be able to:

  • Describe the benefits of routine-based auditory instruction
  • Identify two auditory planning frameworks
  • Identify two routine-based monitoring tools

Cochlear Implants and Auditory Neuropathy Spectrum Disorder
Jeffrey L. Simmons, MA, CCC-A

Auditory neuropathy spectrum disorder (ANSD) is a relatively new category of hearing loss, and there continues to be some confusion and misunderstanding regarding whether and when cochlear implants are an appropriate intervention for this condition. This session will review current literature reports of outcomes for cochlear implants in cases of ANSD as well as a stepwise protocol leading to potential cochlear implant candidacy. We will discuss expanded application for cochlear implants in the population of persons with ANSD as well as factors for which cochlear implantation may be contraindicated.

After completing this session, you will be able to:

  • Discuss a stepwise protocol for identification and remediation of ANSD
  • Summarize outcomes for the population of patients with ANSD who have received cochlear implants
  • List factors in cases of ANSD that can be used to help formulate realistic expectations for outcomes
  • Describe instances in which proceeding with cochlear implantation may not be warranted or may be contraindicated

Cochlear Implants as Possible Treatment for Asymmetric Hearing Loss or Single-Sided Deafness
Jill B. Firszt, PhD, CCC-A

Providing clinical care and recommendations to improve communication abilities for individuals who have asymmetric hearing loss (AHL) or single sided deafness (SSD) can often be challenging. This session will review the importance of binaural hearing, describe the effects of AHL or SSD, present results from individuals with AHL or SSD after cochlear implantation, and discuss future considerations for treatment.

After completing this session, you will be able to:

  • Describe two deficits of individuals who have AHL or SSD
  • Describe two benefits of cochlear implantation for individuals who have AHL or SSD

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